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CITY OF SAN JOS &,,jr BUILDING DEPARTMENT
�PPLICATION FOR BUILDING PERMIT
Date. -,r................-, 19.(�
� /"" P r No.---c�703--�---------- -
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Application is here de ora permit t /,�. ... .. ---------------------------------------------
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a-------/.......story, Ty -' - - ...- -. .' .........*---------------------------- Building
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to lbe occupied only as / --1",IP5� k
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in accordance with Plans, Specifications an& Plof-plan filed herewith.
Estimated Value of Improvements, $.-1/-/ --------------------------
It is hereby,agreed that the requirements of ta San Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will be
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
any m
son in�,mann r 0 f violate the workman's compensation law of Calliforn' .
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Own r --- -- -- ...Address ------
..........Address —------- -------------------------------------
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Contract. Agent
Form 280-1
'RECORD OF INSPECTION
Foundation ----------- - me -
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